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Wrinkles are creases in the skin.

Most wrinkles are associated with aging changes in skin. Aging of the skin and related structures (hair and nails) is a natural process. Nothing can be done to decrease the rate of skin aging, but many environmental factors will increase the rate.

Frequent exposure to sunshine results in premature skin wrinkling and increased pigmentation (liver spots). It also increases the likelihood of skin cancer. Exposure to cigarette smoke is another environmental factor that increases wrinkling of the skin.

Besides wrinkles, other skin changes may include liver spots (pigmented areas). The hair and nails also change with aging, including graying of the hair, hair loss, and brittleness of the nails.

Common causes of wrinkles include:

• Genetic (family) influences
• Normal aging changes in the skin
• Smoking
• Sun exposure

To minimize skin wrinkling, stay out of the sun as much as possible. When you are outside, wear protective clothing and use sunscreen. If you smoke, stop smoking.

Wrinkles are not usually a concern unless they occur at an early age. Consult your health care provider if you think that your skin is becoming excessively wrinkled at an early age. A referral to a dermatologist or plastic surgeon is sometimes appropriate.

Your doctor may ask detailed questions about your wrinkles, such as:

• When did you first notice that the skin was abnormally wrinkled?
• Has it changed in any manner?
• Has a skin spot become painful or does it bleed?
• What other symptoms are occurring at the same time?

A detailed examination of the skin will be performed. If wrinkles are accompanied by a skin lesion that has changed in appearance, diagnostic tests may include a skin lesion biopsy.

Tretinoin (Retin-A) or creams containing alpha-hydroxy acids may be recommended, but these aren't guaranteed to help.

Chemical peels or laser resurfacing are very effective options for early wrinkles.

Botulinum toxin (Botox) may be used to correct some of the wrinkles associated with overactive facial muscles.

Some patients may choose plastic surgery for age-related wrinkles (for example, a facelift).

Updated by: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.